SYSTEMATIC REVIEW article
Front. Oncol.
Sec. Cancer Genetics
Clinical Impact of Clonal Hematopoiesis on Patients with Solid Tumors: A Systematic Review and Meta-analysis
Vlad Croitoru 1,2
Adina Turcu-Stiolica 3,4
Adina Emilia Croitoru 1,5
Doru Paul 6
Razvan Iacob 7,5
Alina Daniela Tanase 1,5
Adrian Saftoiu 5,8
Irina Sandra 5,7
Cristiana Tanase 2
Irina M. Croitoru-Cazacu 5,1
1. Fundeni Clinical Institute, Bucharest, Romania
2. Universitatea Titu Maiorescu Facultatea de Medicina, Bucharest, Romania
3. Universitatea de Medicina si Farmacie din Craiova Facultatea de Farmacie, Craiova, Romania
4. Universitatea de Medicina si Farmacie Iuliu Hatieganu Facultatea de Medicina, Cluj-Napoca, Romania
5. Universitatea de Medicina si Farmacie Carol Davila din Bucuresti Facultatea de Medicina, Bucharest, Romania
6. Weill Cornell Medicine, New York, United States
7. Institutul Clinic Fundeni, Bucharest, Romania
8. Spitalul Universitar de Urgenta Elias, Bucharest, Romania
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Abstract
Introduction. Clonal hematopoiesis (CH) is a common age-related phenomenon associated with an increased risk of hematologic malignancies and cardiovascular disease. Its prognostic significance in patients with solid tumors remains unclear. The aim of this meta-analysis was to evaluate the association between CH and clinical outcomes, including overall survival (OS), progression-free survival (PFS), cardiovascular events, and all-cause mortality in patients with solid tumors. Methods. We conducted a meta-analysis according to PRISMA guidelines, including 21 studies comprising 4845 patients with CH and 63557 patients without CH. Hazard ratios (HRs) and odds ratios (ORs) with 95% confidence intervals were pooled using random-effects or fixed-effects models as appropriate, based on assessments of between-study heterogeneity. Results. CH was not significantly associated with OS in patients with solid tumors (HR: 1.10, 95% CI: 0.92–1.32, p = 0.30). The pooled analysis using a random-effects model suggested a trend toward improved PFS in patients with CH compared with those without CH, although statistical significance was not reached (HR: 0.83, 95% CI: 0.67–1.02, p = 0.08). However, CH was associated with an increased mortality in patients with solid tumors, with nearly a twofold higher risk compared to those without CH (OR = 1.70, 95% CI: 1.34-2.16, p < 0.00001). Furthermore, CH was significantly associated with an increased risk of cardiovascular events (OR = 2.75, 95% CI: 1.38 to 5.47, p = 0.004). Conclusion. Our meta-analysis indicated that CH mutations have a prognostic value and are associated with a clinically meaningful increased risk of overall mortality and cardiovascular events in patients with solid tumors.
Summary
Keywords
cardiovascular events, ChIP, Clonal hematopoiesis, prognosis, solid tumors, Survival
Received
17 December 2025
Accepted
17 February 2026
Copyright
© 2026 Croitoru, Turcu-Stiolica, Croitoru, Paul, Iacob, Tanase, Saftoiu, Sandra, Tanase and Croitoru-Cazacu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Adina Emilia Croitoru
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